Neil Cockburn (5th place) – Why is Global Health important and how is it taught in medical school?

1397682_10153519531635471_590376483_oNeil Cockburn  Fifth place in the Manchester Global Health Competition 2014. Neil Cockburn is a third year medical student at Manchester Medical School with an intercalated BSc in Global Health. He is particularly interested in public health and health systems, but is happily over-opinionated on many subjects.

Global health should be taught in a way that is directly relevant to students and changes the way they think about medicine. For many students, global health may conjure up images of tropical medicine and exotic locations far removed from the future practise of most medical students, but in truth it can describe almost everything that medics do. From the health systems we are a part of (both NHS and international) to the social reasons refugees, immigrants and any other marginalised or less privileged group may suffer worse health, global health defines everything doctors, medical teams and health services do. There is a great deal to be learned from foreign countries in both Global North and South that can impact our future practise. Examining successes in both high and low resource settings can drive an appreciation of the entire NHS – or a desire for reform, if it is found wanting. Furthermore, connections to other countries can reap benefits throughout our careers, to us as individuals, to those countries we are connected to and to the hospitals and NHS we may work in. Many students want to travel and work in different healthcare settings during their careers, yet other than vague altruistic intentions, they may have little knowledge of the benefits of these expeditions. Leadership development, sharing innovation and better relationships with local diaspora communities can have significant benefits long after the journey’s end. Global health teaching should also help maximise local impact abroad to try to leave lasting improvements – or at least do no harm while away. Students should be fully aware of the pitfalls of working in less economically developed countries and the harm that has been done by poorly conceived programmes, and realise the power and privilege they will wield as a result of their probable wealth and education. Political and social naiveté can mitigate positive impact, so medics should be aware that their actions are rarely ‘neutral’. However, the vast array of global health actors can be confusing, and teaching in this area can be a real opportunity to help understand the grand scheme of our actions both at home and away. Global health teaching has the potential to change the way we view medicine and the world. It can prepare us for working abroad, for critically appraising our own health systems, and enhance our future practice. Dr. Fisher, a Manchester GP describes her “wilderness” of a local practice, and how the social determinants of health have far more impact on her patients’ health than the healthcare she can provide. This may be the key lesson for medical students: the world beyond the walls of our own hospitals and surgeries affect people’s health more than we ever will, with some researchers claiming under 5 additional years life expectancy to the development of allopathic medicine. The way we learn global health must be relevant, and a new paradigm should affect the way we practice and understand our populations – both locally and globally.

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